Factor structure and reliability of the Arabic adaptation of the Hypomania Check List-32, second revision (HCL-32-R2).

OBJECTIVE: To assess the psychometric properties of the Arabic adaptation of the Hypomania-Check-List 32-item, second revision (HCL-32-R2) for the detection of bipolarity in major depressive disorder (MDD) inpatients suffering a current major depressive episode (MDE). METHOD: The "Bipolar Disorders: Improving Diagnosis, Guidance, and Education" Arabic module of the HCL-32-R2 was administered to mother-tongue Arabic MDE inpatients between March 2013 and October 2014. Diagnostic and Statistical Manual Fourth edition (DSM-IV) diagnoses were made adopting the mini-international neuropsychiatric interview, using bipolar disorder (BD) patients as controls. RESULTS: In our sample (n=500, of whom, BD-I=329; BD-II=70; MDD=101), using a cut-off of 17 allowed the HCL-32-R2 to discriminate DSM-IV-defined MDD patients between "true unipolar" (HCL-32-R2(-)) and "sub-threshold bipolar depression" (HCL-32-R2(+)) with sensitivity=82% and specificity=77%. Area under the curve was .883; positive and negative predictive values were 93.44% and 73.23% respectively. Owing to clinical interpretability considerations and consistency with previous adaptations of the HCL-32, a two-factor solution (F1="hyperactive/elated" vs. F2="irritable/distractible/impulsive") was preferred using exploratory and confirmatory factors analyses. Item n.33 ("I gamble more") and n.34 ("I eat more") introduced in the R2 version of the HCL-32 loaded onto F1, though very slightly. Cronbach's alphas were F1=.86 and F2=.60. LIMITATIONS: No cross-validation with any additional validated screening tool. Inpatients only sample; recall bias; no systematic evaluation of eventual medical/psychiatric comorbidities, current/lifetime pharmacological history, or record of severity of current MDE. CONCLUSIONS: In our sample, the HCL-32 fairly discriminated between MDD and BD-I but not BD-II, therefore soliciting for replication studies for use in Arabic-speaking depressed inpatients.

Coping strategies in egyptian ladies with breast cancer.

INTRODUCTION: A diagnosis of breast cancer regardless of the stage can be stressful, impact multiple spheres of life, and disrupt physical status, emotional and spiritual well-being, and personal relationships for the patient and family. In order to adapt, the patient ought to employ certain coping mechanisms. Individuals with terminal illness who utilize coping strategies have better quality of life compared to those who do not. PATIENTS AND METHODS: This study aimed to determine the strategies used by females with breast cancer to cope with such stress by using Brief COPE scale and the hospital anxiety and depression scale. The study included 56 female patients diagnosed with operable breast cancer at Mansoura Oncology Center before surgery. RESULTS: Large proportion of patients used acceptance, religion, and emotional support in coping with the stress of having breast cancer. Patients with depressive symptoms scored significantly higher venting while those with anxiety scored higher positive reframing, planning, and venting. CONCLUSION: Efforts should be made to encourage women with breast cancer to use coping strategies that have been found to be helpful (eg, acceptance, emotional support, distraction, and active coping strategies).

The reliability of the standard for clinicians' interview in psychiatry (SCIP): a clinician-administered tool with categorical, dimensional and numeric output.

BACKGROUND: Existing standardized diagnostic interviews are not used by psychiatrists in clinical settings. There is an urgent need for a clinician-administered tool for assessment of adult psychopathology that produces dimensional measures, in addition to categorical diagnoses. METHODS: The Standard for Clinicians' Interview in Psychiatry (SCIP) was designed to be used in clinical settings and generates dimensional measures. The reliability of the SCIP was tested at six sites: one hospital and two clinics in USA, two hospitals in Egypt and one clinic in Canada. Participants were adult patients who were admitted for inpatient psychiatric treatment or came for regular office visits in the outpatient clinic. Refusal rate was <1%. Missing data were <1.1%. Patients with dementia, mental retardation or serious medical conditions were excluded. A total of 1,004 subjects were interviewed between 2000 and 2012. RESULTS: Inter-rater reliability (Kappa) was measured for 150 SCIP items: 116 items (77.3%) had good reliability (Kappa>0.7), 28 items (18.7%) had fair reliability (Kappa ranges from 0.5 to 0.7) and six items (4%) had poor reliability (Kappa<0.5). Cronbach's alpha for internal consistency was measured for the SCIP dimensions: anxiety, posttraumatic stress, depression, mania, hallucinations, Schneider first-rank symptoms, delusions, disorganized thoughts, disorganized behavior, negative symptoms, alcohol addiction, drug addiction, attention and hyperactivity. All of the SCIP dimensions had substantial Cronbach's alpha values (>0.7) with the exception of disorganized thoughts (Cronbach's alpha=0.375). CONCLUSIONS: The SCIP is a reliable tool for assessing psychological symptoms, signs and dimensions of the main psychiatric diagnoses.

Effect of weight reduction on the quality of life in obese patients with fibromyalgia syndrome: a randomized controlled trial.

The aim of the study was to examine whether weight reduction can result in improvement of fibromyalgia impact questionnaire (FIQ) in the patients with fibromyalgia syndrome (FMS). This study was a randomized controlled trial. Obese patients with fibromyalgia were randomly assigned to 6-month dietary weight loss (n = 41) and no weight loss (n = 42) groups. Patients were assessed at baseline and at 6 months. The primary outcome measure was FIQ. Secondary measures included the tender point (TP) examination, Beck Depression Inventory-II, and Pittsburg Sleep Quality Index. Compared to the control group, patients who underwent weight reduction obtained significantly better FIQ (p = 0.007), lower mean TP count (p = 0.015), and lower mean TP pain rating in the lower body (p < 0.001). Patients who lost weight had less depression and better sleep quality than the controls. Patients who lost weight had significantly lower interleukin 6 and C-reactive protein levels than those in the control group (p = 0.034 and p = 0.007, respectively). Weight loss in obese patients with FMS leads to significant improvement in the quality of life as shown by the decrease in the FIQ score. Depression, sleep quality, and tender point count are also significantly improved by weight loss in obese patients with fibromyalgia. Our results suggest that weight reduction should be a part of fibromyalgia treatment.